I'm on the ferry with lots of my family, we lose each other: a case of Physalia physalis

by Gordon Adam

The patient is a
woman of 27 who came to see me with conjunctivitis of the left eye since a
holiday in Greece
3 weeks ago. It started the same day as she got sunburned and a cold sore on
her lip. The cold sores have been “quite vicious” appearing on the right corner
of her lip for the last 6 months. Her eyeball is red and itching – “like ants
crawling behind my eyes.” She is woken at night by heat, dryness and itching in
her eye. Her eyes feel swollen. She feels better being outside, in cool, breezy
weather. She has had antibiotics, antihistamine and ‘antiviral’ drops from her
doctor, but the problem is getting worse. In the last few weeks, her sleep has
been light and sporadic, her energy is low and she has lost her enjoyment of
food.

She is a singer
and singing teacher and started a new teaching job 6 months ago. She has been
feeling low and tired and stressed by a difficult pupil and by money. She is finding
it difficult to relax and switch off. She is quite active and likes to be
productive. She is sociable, happy and excited easily by small things, but her
mood drops off every 6 weeks or so, when she can feel quite negative about
herself. She is sensitive to rudeness, unfairness and injustice – this makes
her feel “angry and powerless.” She gets
“frustrated by things happening beyond my control.” She says she is “very tidy
– too tidy. I’m always worried I’ll forget something – I never let myself off
the leash.” “I try and plan my time and work so I do everything in a considered
way so that everything is done properly.”

She likes being
outdoors and walking by the sea. “I love water.” One of her hobbies is
sail-making. She likes windy weather: “I’ve got something to lean against if
it’s windy.” She enjoys travelling and travels a lot for work. “I’ve travelled
too much this year and feel world weary.”
She likes eating shellfish, sushi and fish. She feels nauseous if she
eats rice. She drinks a lot of water, 4 litres a day.

She is <
before menses: her premenstrual symptoms include irritability. Her mother says
she is “nasty and hurtful” before her period], skin eruptions (spots), nausea,
aching knees and elbows. She craves prawns before her period but these make her
vomit. Her periods are variable, better since taking the contraceptive pill for
the last 3 years.

Her mother (who
is also my patient) describes her as very considerate, conscientious, generous
and selfless, but also as overanxious, very self-critical; she pushes herself a
lot and expects too much of herself. She is dyslexic and has a very high IQ.

Prescription: Sepia200 (x2)

Follow-up 1 month: she generally feels better. Her energy
has improved and her sleep is more restful. Her eyes have stopped itching at
night, but they still feel swollen and aching. Her left eye feels “too big for
the socket”. Itching < daytime, smoke, air conditioning in car. Eyes ache
< continued use of eyes, > cold water. Itching and achiness comes and
goes in phases of a few days at a time. Her premenstrual symptoms are not
better.

For the last 2
weeks, she has been having dreams about car ferries (she has had these dreams
in the past) : “The sea starts calm and gets stormy, or starts stormy and then
becomes calm. I’m on the ferry with lots of my family – we lose each other and
are searching for each other. The ferry is at an angle (almost 90 degrees) and people
are walking on the sides. We need to get off the boat because it’s stormy and
the boat is sinking or we’re in peril.”

Overall she is
feeling about 50% better. “I feel much more normal – I feel I’m getting back on
track.”

Prescription: Pulsatilla30(bd x3)

Follow-up 6 months: her eyes got a bit better after the Pulsatilla
but did not clear up. She has been using saline drops for her eyes; the doctor
thinks she has ‘dry eye syndrome’. She is "on the go all the time".

Follow-up 8 months: she is still having trouble with her
eyes: both eyes get red, bloodshot; < left; with intermittent itching on
edges of eyelids. “I get a cramp at the back of my eye – something twists and
tightens (HG – she twists and contracts hands) – then my eyes suddenly go red
and achy.” Her eyes have become sensitive and reactive.

Tell me more
about that hand movement? “It’s like there are little tentacles on the back of
my eyes – it’s like they cramp up and retract and stiffen.”

Her mother had
reminded her to tell me about something that happened when she was 12 on
holiday in Italy:
“I was swimming with my dad and there had been an influx of jellyfish –Portuguese
Man-of-War. I saw something that I thought was a plastic bag floating in the
water and I swam towards it. I got stung all over my body; on my feet, legs,
abdomen; it left ‘tyre-marks’ on my belly. I started to go into shock. I was
taken to First Aid; I had lots of injections (antihistamine?). It was an
emergency; I nearly died. I had to take antihistamines and steroids for 6
months afterwards.”

Her mother said
she “wasn’t herself” for a long time after being stung. Since that time, she
has reacted strongly to bites and stings, with blistering and swelling of the
affected part.

Tell me about
your relationship with the sea?“I like the sea;
I get very scared of its strength. When I was a toddler, I was very scared of
the sea. I adore it if it’s calm and clear – I stay in the water for hours. I
like snorkeling. I like being by the seaside; I like heat and sunbathing. As
a child, I wanted to be a marine biologist and I was a member of dolphin and
marine clubs. I’ve always had blue bedrooms and dolphin mobiles on my ceiling. I love (to eat)
raw fish, smoked fish, oysters, shellfish. I love all crustaceans apart from
mussels.”

Prescription: Physalia physalis 30(x2)(Portuguese
Man-of-War)

Follow-up 10 months: A week after
taking the remedy, she was itching in the places she was stung by the
jellyfish. She had headaches above her right eye; “like a dull, sharp, deep
pain – as if I wanted to grab it.” Her
eyes cleared up a lot: “They seemed to clear for several weeks, better than
they’ve been for ages; they looked bright again, but have been worse again in
the last 2 weeks."

She has been
very busy, work has been “all consuming”; “It’s been a bit of a yo-yo, trying
to be all things for all people.”

Have you noticed
any other changes since you had the remedy? “I have felt a
bit more fluid. I feel a bit less in control – I’m flowing from one thing to
another. I’m used to being the director or orchestrator of what I do. I have a
tendency to hold on to things, to make things happen, to be responsible, vs.
allowing someone else to be responsible. ”I’ve been
thinking a lot about my connection with the sea. I’ve been consumed with that
time in my life – from 10-14 years old. I remember jumping off a cliff into a
deep sea – I keep thinking ‘How did I do that?’ – that feels like a distant
person.”

Her fiancé has
been away a lot with work – “He’s been really distant – physically and
emotionally.” She suspects he is having an affair. “I feel vulnerable,
abandoned and angry. I’m the one at home dealing with everything, it’s a bit
unfair. I’m realising I can’t fix everything. I’ve been crying a lot –
something’s releasing."

"I liked the remedy: when I took it, when it was in my
mouth, in my blood – I liked it.”

Prescription: Physalia physalis200(x2)

Follow-up 12 months: (4 months since first prescription of Physalia) The remedy
worked really well and her eyes have been sparkling clear ever since. Her
mother says: “It’s as if the remedy has taken the scales from her eyes and
she’s beginning to see the real source of her problems. She is becoming a lot
stronger, mentally as well as physically. A lot of other issues have risen to
the surface, including the troubles with her partner, who’s been having an
affair.”

Follow-up 16 months: (8 months since first prescription of Physalia)“I have grown a bit in
some ways; my spine feels longer. A number of people have said I look taller,
as if I’d been carrying a weight on top of my back before.
“My eyes have cleared up and they’ve been fine. They’re getting bluer – my eyes
are back to how they used to be. I was crying a lot for 2 months after taking
the remedy, and I found it difficult to speak or sing; it was the most silent
I’ve ever been in my life.
“We were engaged but my fears that he was having an affair proved to be right.
We were together for 5 years.
“I moved him out 3 months ago and put
all his stuff and boxes in a van; at the time I was scared – I didn’t know what
I was doing.”

How do you feel now?
“Amazing – everything’s amazing now! Everything feels lighter, younger and
sillier.
“My work is really easy but fulfilling; for the first time I can say I’m
finding work easy. It’s fun work and I don’t have to prove anything to anyone.”

Do you feel your
relationship with work has changed?
“Yes, before I felt I had to prove a lot, either to myself or to my ex-partner.
I was trying to make myself more mature, more valid. Also, I was tired, like a
‘tired turtle’ – as if I had a shell on my back, and my posture was rounded.
“I’m relying less on my brain and trusting my instincts more; I don’t feel I
need books and papers around me now. I feel I’m carrying less mentally as well
as physically.
“For the last few months, I’ve been talking to myself in silly voices and
making myself laugh. I used to do that before, but not for the last 5 years.
“My voice has been dropping – it’s deeper – it feels different.”

What do you feel the role of
the remedy has been in all of this?
“Even before I put it in my mouth, it felt like a strong remedy – as if it was
trying to jump out of the packet. It is strengthening – bringing strands
together.
“A Portuguese Man-of-War will only sting something with tendrils – as if your
energy is fractious; if you’re more contained, whole, then they won’t.”

She had earlier described how she hadn’t been getting on with her parents very
well around the time she got stung, and she felt people weren’t understanding
her.

“When my eyes were bad, it was like fraction, things being split, like a
cracked window. After the remedy, it looked like my eyes had come together
again vs. being fractured.
“There’s something less tumultuous. I don’t feel like I’m in the sea anymore –
I feel I’m standing on the ground. I’m no longer scared of the sea. After I
took the remedy, I went swimming a lot in the sea – I’ve remembered my love of
the sea – the fear came after being stung.”

What was your experience of swimming in the sea?
“I felt it was something I was doing for me and not for anyone else – it was
something I needed to do. Even when I was upset and grieving, the one thing I
would do is sit, or walk by, or go swimming in the sea – it’s been like coming
back to myself.
“I used to have lots of dreams of ferries, tumultuous seas, seas of mud, red seas
– I haven’t had any dreams like that for the last few months.”

She had actually been having these dreams for several years – since she’d been
together with her ex-partner.

“I hear lots of different
rhythms; I realise my feet are tapping, or my hands are tapping; as if I’ve got
music in my head.
“I’ve been writing lots of songs and
been enjoying singing. I’ve been listening to a lot of music – more than for
years. I’ve been dancing around the room whenever there’s music on.”

What about being fluid?
“I’m more allowing people to have responsibility for themselves vs. overly
planning; I’m letting the day flow for itself. Before, I was determined to control
things vs. let things flow.
“I’ve started running by the seaside.”

Follow-up 1 year after the last
appointment: “A lot has
happened. I’ve moved, got some great new work, and have lots of friends around
me. The old house was sold which was a great relief. My health and energy have
been great ... I can only thank you for your all your help over a very tricky
time.”

AnalysisI think the
choice of Physalia physalis as a remedy is fairly self-explanatory, given the
richness in sea imagery and the dramatic and vivid aetiology of the case.
However I would like to highlight some ‘doctrine of signatures’ and materia
medica connections that may be less obvious:

The SeaSo much mention
is made of the sea that it would be hard not to think of a sea remedy for this
patient! Also, the “never been well since” incident was in the sea. So, the sea
inflicted the wound, and after the remedy, the sea assumes a very healing role
– so the circle is complete.

Animal language There is plenty
of animal language in the case, suggesting the patient needs an animal remedy: Vicious; nasty
and hurtful; all consuming; I never let myself off the leash; like ants
crawling; there are little tentacles on the back of my eyes”. Various marine
animals are mentioned – “like a tired turtle”, dolphins, oysters, prawns,
shellfish, mussels, crustaceans.

Dreams of ferries“I’m on the
ferry with lots of my family – we lose each other and are searching for each
other. The ferry is at an angle (almost 90 degrees) and people are walking on the
sides.”

Despite its
appearance, the Man-of-War is not a true jellyfish but a siphonophore, which is
not actually a single creature, but a colony made up of many minute individual
organisms called zooids. Each of these zooids is highly specialised, and they
are attached to each other and physiologically integrated to the extent that
they are incapable of independent survival. So, Physalia is actually a floating
family of individual but co-dependent organisms.

The ferry being
at an angle is also interesting: The Man-of-War is found in warm water seas
floating on the surface of the open ocean, its air bladder keeping it afloat
and acting as a sail while the rest of the organism hangs below the surface. It
has no means of self-propulsion and is dependent on winds, currents, and tides
(unlike Medusa, Aurelia aurita, which can swim gracefully). Man-of-War have
different ‘angles of sail’ to ensure widespread propagation. The patient mentions
sail-making as a hobby and likes the wind as it gives her “something to lean
against.” She travels a lot, globally (like Physalia), and feels “world weary”.
Her mother says: “She’s on the go all the time.”

The separation
from her family in the dream reflects a separation in real life: “As an early
teenager, I didn’t get on with my mum well; I didn’t get on with my parents; I
felt people didn’t understand me.” There is a general curative move in the case
from split, separation, disconnection, fraction; to “bringing strands together”
on different levels.